• 제목/요약/키워드: Trouble cases

검색결과 61건 처리시간 0.027초

프라이버시 보호 및 부인방지를 제공하는 택배 시스템 제안 (Privacy Protection and Non-repudiation Mechanisms for Parcel Service)

  • 최민석;조관태;이동훈
    • 정보보호학회논문지
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    • 제22권6호
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    • pp.1283-1292
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    • 2012
  • 최근 택배산업의 성장과 물량이 급격히 증가하면서 피해 사례가 계속해서 늘어나고 있다. 현재 택배서비스 이용 시 피해가 발생한 경우 책임소재 입증불가 및 사업자의 책임회피로 택배 이용 고객들은 피해보상을 제대로 받지 못하고 있다. 특히 운송물 분실 시 택배사업자와 수하인 또는 대리인의 책임소재를 입증할 수 있는 증거자료가 부족하기 때문에 책임이 불명확하고 책임소재 파악을 위하여 많은 시간이 소요된다. 이를 사전에 방지하기 위해서 관련된 증거를 생성, 수집, 유지, 활용, 입증 등이 반드시 필요하다. 본 논문에서는 택배 운송장에서 발신자 정보와 수신자 정보를 암호화 및 코드화하여 개인정보를 보호한다. 또한, 피해 사례 발생 시, 정의된 발신 코드 및 수신 코드를 이용하여 발신 배송 수신에 대한 명확하고 신속한 책임 소재 파악이 가능하도록, 효율적이고 안전한 부인방지 프로토콜을 제안한다.

잠재성 혈우병 환아에서의 편도 적출후 심한출혈의 1치험례 (A Masked Hemophilia B, Severe Bleeding after Tonsillectomy and Adenoidectomy)

  • 박영서;김기헌;김선무;이종무
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1972년도 춘계종합 학술대회 초록집
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    • pp.17.1-17
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    • 1972
  • 편도적출은 우리 이비인후과 임상에서 평소에 다반사로 행해지는 수술의 하나이라 하겠다. 수술술기의 개량, 마취의 발달과 더불어 각종 항생제의 발견등은 편도 적출술에 따르는 여러 가지 합병증을 감소시켰지만, 이중 수술중 또는 수술후에 왕왕 당하는 출혈문제는 가장 흔한 합병증의 하나이며 술자에게는 골치거리의 하나이기도 하여 아직껏 국내외에서 그 보고가 끊어지지 않고 있다. 특히 본증례에서와 같이 본태성 질환으로 인한 출혈의 해결에 있어서는 더욱 복잡곤란한 문제가 많을 것으로 생각된다. 혈우병은 1950년대에 이르러 각 Factor가 발견되어 현재는 혈우병 A.B.C.로 나뉘고 있다. 본증례는 11세의 남아로서 편도 척출술전에는 혈우병의 유무가 인지 못되었던 예로서 수술후 수술창에서 계속되는 출혈로 혈액응고장애를 가진 질환이라고 생각되어 여러 가지 검사결과 P.T.C의 결여로 오는 혈우병 B란 진단을 얻었기에 교훈적이고 귀중한 체험을 얻었다고 생각되어 보고하는 바이다. 환자는 수차의 수혈과 비인강탐폰 등의 방법으로 겨우 지혈되어 수술 20일만에 수술창이 치유되어 퇴원하였다.

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정상한국인의 청력검사치에 관한 연구 (A Study for the Norms of Audiometric Tests in Koreans)

  • 오혜경;서장수;이근해;김희남;김영명;권영화;서옥기
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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    • pp.38.1-38
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    • 1981
  • 현재 이과영역에서 청각기능을 진단하기 위해 순음 및 언어청각검사와 Impedance청각검사등을 이용한 여러가지 특수청각검사법이 사용되고 있으나 우리나라에서는 이에 대한 정상한국인 기준치의 연구가 몇몇 학자에 의해서만 산발적으로 보고되어 왔다. 금번 본 교실에서는 정상 청각기능을 가진 의과대 남학생 100명을 대상으로 일련의 특수청각검사를 실시하여 다음과 같은 기준치를 얻었기에 보고하는 바이다. 1) 언어판별치(PB score)는 전부 90%이상이었고 95%의 예가 우측귀에서는 94%이상이었고 좌측귀에서는 92%이상이었다. 2) M.C.L.(most comfortable level)은 우측귀가 45$\pm$15.4dB이었고 좌측귀는 46$\pm$17.9dB이었으며 그 범위는 우측귀가 11$\pm$12.1dB, 좌측귀는 13$\pm$13.5dB이었다. 3) U.C.L. (uncomfortable level)은 106dB이상이었던 예가 우측귀에서 43%, 좌측귀에서 45%였고 나머지 예에서는 95%의 예가 우측, 좌측 귀에서 모두 96dB이상이다. 4) SISI(short increment sensitivity index)는 95%의 예가 우측귀에서는 1,000Hz와 4,000Hz에서 각각 45%, 45%이내였고 좌측귀에서는 각각 55%, 70%이내였다. 5) Tone decay는 95%의 예가 양측귀 모두 2,000Hz와 4,000Hz에서 10dB이내였다. 6) SRT-PTA(speech reception threshold minus pure tone average)는 우측귀가 -1$\pm$9.2dB이었고 좌측귀는 0$\pm$10.0dB이었다. 7) UCL-SRT(uncomfortable leve minus speech reception threshold)는 UCL이 106dB이상이었던 예를 제외한 57례, 55례에서 우측귀가 98$\pm$11.7dB이었고 좌측귀가 99$\pm$13.5dB이었다. 8) Impedance청각검사 ㄱ) Tympanogram은 1례 (좌측귀, B형)를 제외한 모든 예에서 A형이었고 peak level은 우측귀가 22.8$\pm$32.94mm$H_2$O였고 좌측귀는 23.9$\pm$29.81mm$H_2$O이었다.ㄴ) Compliance는 우측귀가 0.6$\pm$0.54cc였고 좌측귀는 0.6$\pm$0.53cc이었다. ㄷ) 등골근반사(stapedial reflex) $\circled1$ 반대측에 자극음을 주었을 때 반사는 5000z, 1,000Hz, 2,000Hz 및 4,000Hz에서 우측귀가 각각84$\pm$17.7dB, 87$\pm$14.4dB, 79$\pm$13.7dB, 87$\pm$18.6dB에서 나타났고 좌측 귀는 각각 84$\pm$l5.9dB, 88$\pm$13.9dB, 84$\pm$16.8dB, 87$\pm$21.3dB에서 나타났다. 그리고 반사가 보이지 않은 에는 500Hz, 1,000Hz, 2,000Hz 및 4,000Hz에서 우측귀간 각각 1례, 1례, 1례, 3례였고 좌측귀는 각각 2례, 2례, 2례, 5례였다. $\circled2$ 동측에 자극음을 주었을 때 반사는 1,000Hz, 2,000Hz에서 우측귀가 각각 89$\pm$16.3dB, 82$\pm$15.9dB에서 나타났고 좌측귀는 각각 89$\pm$18.0dB, 83$\pm$18.9dB에서 나타났다. 그리고 반사가 보이지 않은 예는 1,000Hz에서만 우측귀가 1례, 좌측귀가 2례였다. 9) Impedance 청각검사를 이용한 구씨관 기능극은 -250mm$H_2O$와 +250mm$H_2O$를 준 때 우측귀에서는 각각 10례, 11례에서 반응이 없었으며 그 반응 범위는 14$\pm$26.9mm$H_2O$, 8$\pm$21.9mm$H_2O$였고 좌측귀에서는 각각 5례, 6례에서 반응이 없었으며 고 반응범위는 각각 2$\pm$22.5mm$H_2O$, 9$\pm$17.3mm$H_2$였다.

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치과방사선 촬영실의 환경 및 안전성에 관한 연구 (A Study on the Environmental Condition and Safety in Dental Radiography Room)

  • 박일순;이경희
    • 한국치위생학회지
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    • 제4권1호
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    • pp.49-64
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    • 2004
  • This study is designed to conduct a questionnaire research into the safety control and the actual condition of radiography by working with dentistry belonging to university hospitals, dental hospitals and dental clinics for three months ranging from August, 2003 to October, 2003. The researcher came to the following conclusions. 1. The research on the current condition of possessed radiational equipment shows that 61.2 percent of the subjects had one intraoral radiation medicine and that 70.1 percent of the subjects had more than one extraoral radiation medicine and that 37.3 percent of the subjects had more than one digital radiation medicine. 2. Most of intraoral radiography (82.1%) was conducted by dental hygienists, and 7.5 percent of intraoral radiography was conducted by nurse aids. On the other hand, most of extraoral radiography (76.6%) was conducted by dental hygienists and digital radiography was conducted by dental hygienists(60.6%), dentists(32.0%) and radiographer(80.0%). 3. The less-than 1-meter-long distance between cone and the radiographer accounted for 44.8 percent. And the more-than 1.6-meter-long distance accounted for no more than 13.4 percent. The exposure time per standard film which was adjusted to each part accounted for 71.6 percent. Fixing the film on the part of healthy patients accounted for 76.1 percent. Fixing the film of elderly patients and children patients by the radiographer accounted for 43.3 percent. 4. The average daily photographing frequency of standard films stood at six to ten pieces(31.3%), and the average weekly photographing frequency of bitewing films stood at less than one piece(47.8%), and the dentistries where bitewing films were not employed accounted for 25.4%. The subjects whose average weekly photographing freqeuncy of occlusal films stood at less than a piece accounted for 59.7 percent. The dentistries whose average weekly photographing frequency of pediatric films stood at one to five pieces accounted for 41.8 percent. In case of panorama & cephalo, one to five pieces on a weekly average accounted for 36.2 percent. The dentistries whose average daily photographing frequency of digital radiation medicine stood at less than 1 piece accounted for 40.0 percent. 5. The research on the use of protective clothes shows that pregnant ·women only accounted for 31.3 percent. In regard to the use of protective clothes in case of the radiographers fixing films, the cases where no protective clothes were employed accounted for 88.1 percent. The reason was said to he attributable to the trouble related to wearing the clothes(54.2%). 6. The survey on the measurement of exposure dose shows that the cases where no measurement was made accounted for 76.1 percent. As far as the measurement methods of exposure dose was concerned, the employment of film badge accounted for 68.8 percent. The subjects turned out to conduct measurement of exposure dose every third month, which accounted for 43.8 percent. The barriers to the measurement of measurement of exposure dose were attributable to the recognition that a little amount of exposure dose need not be measured(29.9%). 7. The survey on the distinction of radiation rooms and clinic rooms reveals that the cases where radiation rooms exclusively existed accounted for 67.2 percent. 43.3 percent of the subjects turned out to have only one protective garment, and 49.3 percent of the subjects proved to conduct a periodical checkup of radiational equipment. The survey on the examination certificates of radiational generators and protective facilities indicates that 80.6 percent of the subjects had the certificates. The research also shows that the subjects with the marks indicating the radiational areas accounted for 70.1 percent. And trustees turned out to handle developing solutions and fixing solutions.

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한국현대여성복식제도(韓國現代女性服飾制度)의 변천과정연구(變遷過程硏究) (A study on the transitional process of clothes in modern Korean women)

  • 남윤숙
    • 복식
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    • 제14권
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    • pp.99-117
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    • 1990
  • The purpose of this study was to investigate the change of clothes in modem Korean women in terms of a socioeconomical background, the introduction to western clothes, and the improvement of clothes between the opening period of ports in the early 1900's and 1960's. In addition, the study investigated how western clothes became popular in a Korean society along with the traditional' Korean clothes, Hanbok. The radical social change since the opening of ports motivated the change in the way of Korean women's thinking, and consequenty the improvement of Hanbok which developed into the clothes-improvement-movement. It was not until 1905 that the improvement of clothes was hotly debated particularly in the matter of abolishing Jangeui and the extreme length of Jeogori and Chima. The Tongchima-Jeogori style which lengthened Jeogori and shortened Chima was widely accepted as everyday wear until the western clothes substituted them after the Independence from Japanese Conquest. As the length of Chima shortened, there occurred a change in Boson and Jipsin as well. There appeared shoes and Gomoosin in place of Jipsin, socks in stead of Boson and were popularized until after the Liberation in 1945. The popularity of Gomoosin diminished markedly with the diversification of shoes styles, due to the improvement of the standard of living with economic development in the 1960's. The traditional Hanbok was gradually differentiated according to the social status, for instance student, teachers, ordinary women, girls and Kisaeng. Especially since the white clothes caused much trouble in washing and sewing, there came into being the movement of wearing colorful clothes. The Movement of abolishing white clothes and promoting of wearing colorful clothes was enforced during the period of Japaness conquest from the 1920's to the Liberation, which consequently stimulated an interest for colors of clothes. The period under the war between 1937 and 1945 was especially noted for the extreme regulation over the clothes. The Japanese government forced each group of women, e.g., girl students, a young women's association, school teachers, and ordinary women and girls, to wear their own uniforms. Also, It recommended the use of Tongchima in stead of long skirts, and buttons in place of Coreum so as to conserve textile encouraging the use of other substitutes to save resources. The western clothes, a model of clothe's improvement was deemed as a symbol of modernization and enjoyed general popularity. The supply of relief clothes after the Korean war accelerated the expansion of western clothes even further and the trend of westernization along with economic progress in the 1960's resulted in wearing of western clothes as everyday dress. The expansion of western clothes as casual wear rapidly diminished wearing of Hanbok which in turn took the position of ceremonial dress worn in special cases only. Hence the Korean women's clothes were dualized into traditional Hanbok and western clothes and the western clothes that stems on its convenience was settled as everyday wear where as the Hanbok appeared as ceremonial dress stressing on ornamental features. As mentioned aboved, we are able to discovered an orientation in the course of transitional process of modern Korean women's clothes admist diversified changes, which is a consistent pursuit of convenience and practicality based upon progmatism. The trend such as this carne into a finale' as women's dress became dualistic in forms of Hanbok and western clothes, and the change since then is supposed to proceed in two forms of dress featuring its own style.

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디지털 사회혁신의 정당성과 민주주의 발전: 온라인 청원과 공공문제 해결 사례를 중심으로 (Legitimacy of Digital Social Innovation and Democracy: Case of Online Petition and Public Problem Solution Project)

  • 조희정;이상돈;류석진
    • 정보화정책
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    • 제23권2호
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    • pp.54-72
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    • 2016
  • 이 글은 최근 주목받고 있는 온라인 청원과 공공문제 해결을 위한 크라우드 소싱 등 디지털 사회혁신(Digital Social Innovation) 사례를 분석하여 시민의 정책 관여가 민주주의에 기여하고 있음을 논증한다. 디지털 사회혁신은 크라우드 소싱이나 온라인 청원과 같은 디지털 기술을 활용하여 정책 수립과 집행 과정에 시민의 참여를 보장하기 위해 노력하는 것이다. 시민의 적극적인 정책 개입을 통해 정책 수립 과정은 물론 정책 자체의 민주성을 강화하는 일련의 과정은 개입 정당성(Throughput Legitimacy)이 강화되는 효과를 가진다. 시민의 동의와 협의 과정은 정책의 투명성, 효과성을 강화함으로써 정책 거버넌스의 질과 효능감을 향상시킬 수 있는 것이다. 이 글에서는 개입 정당성이 민주주의의 발전에 기여할 수 있다는 점을 경험 연구로 증명하기 위해 디지털 사회혁신의 다양한 사례들을 분석하였다. 이를 통해 그 동안 산발적이고 다양하게 시도되었던 디지털 사회혁신이 민주주의의 발전적 요소를 가지고 있고, 다양한 가치를 내재하고 있는 현대 사회의 시민의 참여 효능감을 높이는데 일조하고 있다고 평가하였다. 마지막으로 민주주의의 발전을 위한 개입정당성을 확보하기 위한 노력의 일환으로 디지털사회혁신이 가지는 함의에 대해 제시하였다.

무치악 환자에서 기성 조립식 bar를 이용한 임플란트 피개의치 증례 (Implant-retained overdentures with pre-fabricated bar attachment system in edentulous patients)

  • 소나영;홍영기;하승룡
    • 대한치과보철학회지
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    • 제54권1호
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    • pp.41-48
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    • 2016
  • 치아 상실에 이어 심각한 치조골 소실을 보이는 무치악 환자들은 전통적인 방식의 총의치를 사용하는데 어려움이 많다. 이러한 문제를 보완할 수 있도록 임플란트를 이용한 피개의치가 사용되고 있다. SFI-bar$^{(R)}$는 진료실에서 직접 조정이 가능한 기성품으로 복잡한 기공과정을 필요로 하는 기존의 바 시스템보다 간결하여 시간과 비용을 절감할 수 있다. 첫 번째 증례는 55세 남자 환자로 기존 하악 임플란트-지지 피개의치가 파절되었다는 주소로 내원하였고 내구성이 있으며 통증이 없는 의치를 원하였다. 파절된 Locator$^{(R)}$ 어태치먼트를 제거 후 바를 이용한 피개의치로 치료하였다. 두 번째 증례는 파킨슨병을 앓고 있는 77세 여자 환자로 하악 치조골이 심각하게 흡수되어 의치가 자주 탈락한다는 주소로 내원하였고 통증이 없고 유지력이 있는 의치를 원하였다. 하악 전치부에 두개의 임플란트를 식립한 후 임플란트에 연결된 어댑터에 바를 연결하였다. 그 후 바에 맞는 여성부를 새로운 의치에 장착하여 치료하였다. 2년의 추적 관찰 결과 상기 환자 모두 심미적, 기능적으로 만족할만한 결과를 보였으므로 증례를 보고하고자 한다.

제주 친환경 감귤 농업 발전을 위한 사례연구 - 한농대 졸업생 농가를 중심으로 - (A Case Study on the Development of Environment Friendly Citrus Farming in Jeju - Focusing on Graduate Farms of Korea National College of Agriculture and Fisheries)

  • 강성구;김종숙
    • 현장농수산연구지
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    • 제16권1호
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    • pp.37-53
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    • 2014
  • 본 연구의 목적은 농업후계자들이 대학에서 전문교육을 받고 귀향한 후 친환경농업을 실천하는 데 따른 어려움을 파악하고 이를 해결할 수 있는 방안을 검토하는 데 있다. 본 연구의 조사대상은 전체 한농대 졸업생 감귤농가 24명 중에서 친환경농업을 실천하고 있거나 실천 경험이 있는 총 8명 중 조사에 응한 6농가이며, 개방형 설문지에 의한 사례 연구 방식으로 분석되었다. 사례농가들의 영농실태 분석결과, 이들은 기후변화 및 시장개발에 대응하기 위해 작목전환과 경영의 다각화를 도모하고 있으며, 농법으로는 한 농가만이 무농약 수준의 친환경농업을 희망하고 있고 대부분 유기재배를 지향하고 있다. 사례농가의 경영비 분석결과, 자재비 기준으로 물재비는 더 적게 들지만 관행농업과 같은 수준의 상품성을 얻기 위해서는 노력비가 더 들어가야 하는 것으로 조사되었다. 친환경농업의 생산량은 관행농업에 비해 20-50% 정도 감소하며, 판매가격은 10-50% 높은 것으로 나타났다. 친환경 감귤농가의 애로사항으로는 유기농업 기술 부족과 친환경농업에 적합한 판로부족이며 규모확대를 위한 토지구입이 어려운 것은 제주 농업이 갖는 특수한 제약조건이다. 졸업생 농가의 친환경농법으로의 전환은 부모님과의 합의가 어려운 문제로 나타나고 있으며, 친환경농업 기술을 자문 받을 수 있는 지역의 창구가 없다는 점이 지적되었다. 졸업생농가가 친환경농법으로 전환하기 위해서는 농업기술원 및 농업기술센타를 중심으로 친환경농업 선진농가와의 연계를 통해서 지속적인 기술교육과 자문이 이루어질 수 있도록 가칭 '제주 친환경 생태 유기농업 포럼'을 구성하여 기술자문 및 현장애로 기술이 개발 보급될 필요가 있다. 친환경 감귤의 적정 가격과 판로를 확보하기 위해서는 제주 지역의 로컬푸드와 연계된 판매활동과 육지의 로컬푸드와의 연계도 필요하다. 안전성과 신선도의 가치를 소비자가 신뢰하고 구매할 수 있는 다양한 유통채널을 확보해야 한다. 대부분의 사례농가의 소득증대를 위해서 장기적으로 체험이나 관광과 연계할 수 있는 6차농업의 농장경영을 구상할 필요가 있다. 다양한 품종의 감귤을 도입하여 다양성을 확보하고 체험 및 관광과 연계시켜 생태 유기농장으로 발전해 가야 한다. 이를 위해서는 국내외 선진 농장을 벤치마킹하고 정책사업과 연계할 수 있는 기반을 조성해야 한다. 한국농수산대학에서는 제주지역 졸업생들이 친환경 유기농업을 통해서 경영의 안정을 꾀하고 지역농업의 리더가 될 수 있도록 연구기관 및 보급기관과 연계하여 제주지역에 맞는 지원 프로그램을 개발하고 이를 바탕으로 졸업 후에도 지속적으로 새로운 정보와 기술을 제공해야 한다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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비만클리닉에 내원한 여성의 심리적 특성 (The Psychological Characteristics of Women in the Obesity Clinic)

  • 박샛별;연규월;우행원
    • 정신신체의학
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    • 제11권2호
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    • pp.137-148
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    • 2003
  • 연구목적: 비만클리닉에 내원한 여성들을 대상으로 식이제한 태도 및 우울증상, 스트레스 등 심리적인 문제들에 대한 특성을 파악하고 비만과의 상관관계를 조사하고자 본 연구를 시행하였다.방 법: 2001년 5월 한 달 동안 아주대학교병원과 서울 시내에 소재한 비만 클리닉에 내원한 여성 150명을 대상으로 사회인구학적 특성 및 신체적 특성, Three Factor Eating Questionnaire, Symptom Check List-90-R(SCL-90-R), 스트레스 인지척도 등을 설문 조사하였고 저자가 Hamilton Depression Rating Scale를 측정하였으며, 이 중 설문지의 답을 충실히 기입한 116명을 대상으로 하였다. 결 과: 연구대상 중 체질량지수 $25.0kg/m^2$ 이상인 비만군은 50.0%였으며, 연령이 증가함에 따라 체질량지수가 증가하였다(p<0.001). 정상이하 체중군에서 미혼인 경우가 48.8%로 비만군 13.8%에 비해 유의하게 높았으며(p<0.01), 흡연률 및 음주율과 체질량지수와는 유의한 관계가 없었다. Three Factor Eating Questionniare는 체질량지수와 체지방과 비교해 볼 때 유의한 차이를 보이지 않았으나, Factor 2(Disinhibition)와 Global Severity Index(r=0.27, p<0.01), Factor 3(Hunger)과 Global Severity Index(r=0.24, p<0.01)와는 각각 유의한 상관관계가 있었다. 체질량지수에 따른 Symptom Check List-90-R의 각 증상척도는 편집증 척도만이 과체중군과 비만군 간에 통계적으로 유의한 차이가 있었다(p<0.05). 대상군 모두 Symptom Check List-90-R의 전체 척도가 50점 이하였으나 각 증상척도는 정상이하 체중군과 비만군이 과체중군에 비해 높은 경향이 있었다. Global Severity Index와 Hamilton Depression Rating Scale(r=0.75, p<0.01), Global Severity Index와 스트레스 인지척도(r=0.32, p<0.01) 간에 각각 유의한 상관관계가 있었다. Hamilton Depression Rating Scale를 체지방 정도에 따라 정상군과 비만군 두 군으로 나누어 비교한 결과 비만군에서 우울증상이 유의하게 높았다(p<0.05). 스트레스의 정도는 체질량지수 및 체지방과 유의한 차이가 없었고 대상군 모두 높은 스트레스를 느끼고 있는 것으로 나타났으며, 스트레스 인지척도가 Factor 2(r=0.29, p<0.01) 및 Factor 3(r=0.37, p<0.01)과 유의한 상관관계가 있는 것으로 보아 스트레스가 식이제한 태도에 영향을 미치는 것으로 생각된다. 또한, 스트레스 인지척도가 Symptom Check List-90-R 중 우울척도, Global Severity Index 및 Hamilton Depression Rating Scale와도 유의한 상관관계가 있는 것으로 보아 스트레스가 심리적인 특성에 영향을 미치는 것으로 생각된다(r=0.33, r=0.32, r=0.34, p<0.01). 결 론: 비만한 사람들은 우울을 비롯한 심리적 고통을 더 많이 가지며 스트레스 점수가 높고, 이는 식이제한 태도와도 관계가 있을 것으로 생각된다. 향후 비만클리닉을 방문하는 사람들의 정신과적 문제에 대한 적극적인 평가 및 정신과적 개입이 필요할 것으로 생각된다.

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